Step 1 During or After Core Clerkships, Fall 2016 - AAMC

Your school/program

When did you start studying specifically for Step 1, what resources did you use, and when did you use them?

Did study materials for Step 1, Step 2, and shelf exams overlap at all? If not, how did you schedule your studying for the different tests?

Did you take Step 2 CK soon after Step 1, and How did you balance if so, would you do studying and that again? rotations?

Are there any distinguishing changes to the curriculum or support systems that helped your class succeed?

I definitely forgot a lot of the details from my preclinical year after going through clerkships. However, I knew the clinical presentations cold from having done all of the shelf exams.

I do think I had an advantage on Step 1 by taking it after my clinical rotations, but I think that worked specifically in the context of my curriculum (where we only have one preclinical year, so we still take it right after 2nd year). I think it would be insanely stressful to have to do both Step 1 and Step 2 after 3rd year, when you have so much else going on (ERAS applications). Plus, I think knowing your Step 1 score earlier is important for career Yes, we only have one planning. It would be really preclinical year, and we difficult to be planning on a do all of our clerkships career in a competitive during second year. This specialty and have to readjust means that we have your expectations because of essentially all of third a Step 1 score in the very few year (which is all months between the end of electives and research) 3rd year and when ERAS is to take Step 2. due.

Vanderbilt

My study materials for Step 2 significantly overlapped with what I used for shelf exams (MKSAP and UWorld). However, I didn't take these at the same time. I took the shelf exams I used First Aid throughout my throughout my second preclinical year, but I didn't start year (that's when we do studying in earnest until my dedicated our clerkships), and I 6 week study time. During that time, I took Step 2 CK in March used First Aid, Pathoma, and UWorld. of my third year.

I didn't simply because I was too burnt out from studying. However, if I had been able to find the discipline/motivation to do it within a couple of months of Step 1, I would have. Mostly because I was closer to all the shelf exams then, which were more pertinent to Step 2.

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Yes. Shelf exam studying often helped for both step 1 and 2. 6 months out. USMLE-RX 1st + First Created spreadsheets to Aid Review. Pathoma and Sketchy keep track of what I've Micro/Pharm. Then UWorld and DIT in studied and what I have dedicated time period. left.

I did not, many of my colleagues did after only 2-3 weeks of dedicated step 2 CK study time and they have all reported great results. A well planned schedule. Strengthen.

I didn't study for Step 1 during rotations. I studied for Step 2 during 2 light rotations (Radiology and primary care) when I had a lot of afternoons off.

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When did you take Step 1 and how did Finally, would you that affect VSAS recommend taking Step 1 application timing, if at after third year, and/or do all? Did you have to you have any other tips, delay your application comments, or suggestions? for aways?

Did your third year rotations strengthen your understanding of the pathophysiology or did the gap cause you to forget details?

3rd year first is a MAJOR advantage. It plays out that way for all students I've spoken with in the end despite Yes. Make a schedule. Stick to the anxiety up front. it.

Could you briefly describe your curriculum, specifically how long the pre-clinical period is and when you take Step 1 in relation to core rotations?

I didn't do any aways, but it wouldn't have affected that for my classmates since most people had almost a year between Step 1 and their aways (since we took step 1 in August after our second year and most people didn't do aways until maybe June at the end of third year). See previous questions

Your school/program







Absolutely. The easiest way to conceptualize the benefit of third year is this - you master 90% of the pathophys. and now go back and fill in the 10% composed of tiny step details. For example, you will learn about wilsons disease on internal medicine how it presents, the pathophys., treatment, etc. and then when it comes time to study for step you have to just fill in small gaps by learning the names of the genes their inheritance patterns and some other minutia.

Nothing that sticks out in my mind. We have a new curriculum implemented since our schools founding in 2009.

Absolutely. Step 1 after third year is a full calendar year to further solidify concepts and knowledge that is beneficial to step 1.

The biggest benefit to taking step 1 after third year is the ability to reinforce basic science details during the entire duration of third year. Everything you review/learn while studying in a clerkship will benefit you on step 1; Thus, if you study well for clerkships and truly try to master the material you will be benefiting your future self. My institution allocated 5 designated study weeks at the conclusion of third year (April) and expects most students to sit for the eam between May and early June. Most individuals at my institution find that the 5 week study period is sufficient to perform well on the exam. If one was applying for an especially competitive residency (i.e. ortho, derm., plastics, etc.) that highly regards step scores many students began casually studying towards the end of December or beginning of January usually a few hours a week or setting small work goals to cover a resource or study material prior to designated time. The most regarded/widely used resources were: First Aid, Uworld Q bank, DIT, Pathoma, CBSSA practice exams, Sketchy micro/pharm., UMSLE Rx, Kaplan Q bank, and Kaplan videos.

FIU

I did not due to scheduling conflicts with away rotations for orthopaedics. about half of the student body takes CK within 4-6 weeks after step one some people in the immediate 2-3 weeks after step. The other half will take CK at some point later in the fall. The time to take CK is very dependent on desired specialty. Internal medicine, Gen. Surg., I cannot speak on behalf of all my peers but I can describe a basic use of Yes. Virtually everything etc. require scores for you study for a shelf is in interviews so students resources/timeline that several of us some fashion relevant need to and opt to take used. and beneficial to step CK quickly after step 1. December - March: Watch and studying. Most students For other fields that dont annotate relevant pathoma into First value CK as much Aid 2016, print/watch/annotate Sketch studied exclusively for shelf exams until students take CK later. Micro and sketchy pharm. Some December/January of Generally, most students students opted to do USMLE Rx in wish they took step 2 CK their spare time outside of clerkships. third year. At that point in time most students closer to Step 1. The The bank is written by the writers of overlapped studying for exams are both First Aid and is an excellent way to step with shelf studying. converging and review first aid / learn core material with explanations taken right from the For example, if you are becoming more clinical. on neurology students Most students find that book itself. would study first aid outside of the monotony April - May: First Aid neurology, CNS and not wanting to reading/annotating, USMLE World Q pathoma, etc. Many of buckle down for another bank mixed timed tutor blocks, us found that shelf exam Step 1 details and reviewing sketchy micro/pharm, DIT studying and step concepts are frequent on CK and you will often do Our school offers to purchase either a studying was virtually the same. Shelfs contain better if you take the 6 month UWorld subscription or exams closer together. Doctors in Training (DIT) for students. the same basic knowledge and Many students Most opt for DIT since it is more principles as step outperformed their expensive. It is a solid review course already excellent Step 1 to lay a foundation for studying but is studying just with the added step of treatment scores on CK taking the not enough to achieve very high or diagnostic testing. exam soon after step 1. scores.

Varies from student to student. Some would study rotation relevant step material (like FA neuro on neurology) for half the rotation then use more clinically relevant resources for the second half. Some student studied only relevant step material and performed well. It varied substantially person to person. Overall, if youre studying either for a shelf with shelf geared materials or for step they both are going to benefit your score and knowledge base.

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Your school/program

University of Minnesota - Twin Cities


This survey response is specific just to me (I happen to be the OSR rep, but I'm one of the few people at my school that took step 1 after taking my 8 week medicine rotation). I started studying for step 1 after our last block of course work for 4 weeks, then took an 8 week medicine rotation, then spent the next 6 weeks studying for step 1. I used Doctors in Training, Sketchy Medical, USMLE Rx, and First Aid. I used DIT the first 4 weeks and the rest after completing my medicine rotation.


The medicine shelf and step 1 overlapped a tiny bit, but I mostly focused on step1 during my dedicated studying time and then just studied for the shelf during the medicine rotation.

Duke Medical School

Most Duke students take 4-6 weeks to study for Step 1 right after their MS2 rotations or between fall and spring semesters of MS3. USMLE UWorld and First Aid are the most popular resources.

NYU School of Medicine

Most of us used uworld for step 2ck for shelf exams and for Step 2. We studied for the shelf throughout the clerkship using the qbank and one rotation specific book (ex. blueprints, step up First Aid and Uworld questions. Began to medicine, case files Most of us take Step 2 after core clerkships during dedicated ect.). Step 1 does not CK within a few months study time for Step overlap at all. of Step 1

NYU

For Step 1, no overlap. For Step 2 and shelf exams, I used Uworld Step 2 qbank almost Typically students start studying in late exclusively. For shelf December/early January after exams, I supplemented completing core clerkships. They take with relevant text/review approximately 6 weeks. I personally books (e.g. pestana's, used Uworld and First Aid during first aid for psych, case those six weeks and did not study files for obgyn) but for specifically for Step 1 outside of that Step 2 I exclusively used dedicated time Uworld

Speaking only from personal experience, Step 1 and shelf exams overlap quite a bit.


NOPE - definitely forgot the details step 1 asks.

I would not recommend taking step after any rotations. It is too hard to get the studying done while trying to balance long rotations (especially medicine where I was at the hospital 70-80 hours/week) and shelf studying with step information. I ended up failing my medicine shelf because I did not focus on either the shelf or the step exams and I did not have the knowledge base from having already taken step 1. I do not think that the clinical rotations really help you with the information that step 1 focuses on because those questions are too detailed. The residents and physicians that you are working with on the rotations do not even know that No, this is a new thing at information anymore so if you our school and I was ask questions about it during one of the few people the rotations you really don't that did it that way. get great answers.

1-3 hours of scheduled reading/questions every night after coming home, depending on the time demands of the rotation.

I took Step 1 after rotations. Rotations helped a lot with the big picture, while some of the finer details had to be relearned for Step 1.

Flexibility. Students can take Step 1 at any point during their third year. Some students--like me--felt that studying for Step 1 right after taking shelf exams was very helpful, while others felt burned out after rotations and were able to better approach their dedicated study time Overall, flexility is key. No after spending a few single solution will work for months doing research. every student.

Less sleep

Me personally it probably caused me to forget pathophys for certain things like drug mechanisms, but strengthened things like organ systems.


No, I will be taking step 2 in the fall of 2017 and took step 1 August of 2016.

I didn't and wish that I had.

I am an MD/PhD, so I took Step 2 five years after taking Step 1. Typical students at my school take Step 1 in February of third year and then take Step 2 sometime between July and January of 4th year, depending on personal preference.



I didn't - it was nearly impossible to overlap step studying with shelf studying/rotations.

During rotations I tried to study for a bit on at least half the days when I got home and also on weekends. I took two weeks of dedicated study time for Step 2

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I think it strengthened my understanding. I definitely have gaps but they tend to be in the very basic biochem and pharmacology type of stuff that we learned first year and less the pathophysiology

MS1 -- basic science, MS2 -- clinical rotations, MS3 -research/scholarly experience, MS4 -VSAS application timing clinical rotations. Step 1 has never been an issue is most commonly taken at Duke. We take Step during MS3, either at the 1 during our research very beginning or over year. the winter break.

I would recommend reading step 1 during pre-clinical years on the subject that your coursework is covering. Taking Step 1 after clerkship year does seem to help the majority of people perform February, and it didn't better on the exam. delay VSAS

not sure, although the average step 1 score did go up after the change to an 18 month preclinical curriculum and taking step 1 after clerkships yes, I think it helps


pre-clinical of 1.5 years followed by core rotations of 1 year and then Step 1.

18 month preclinical. MD/PhDs take Step 1 at the end of the 18 months. All other med students go on to do 12 months of core clerkships and take Step I didn't do aways. I don't 1 at the end really have a sense from (approximately February my classmates whether of the third year of med this was an issue school total)

Your school/program

Baylor College of Medicine

BCM

Perelman School of Medicine at UPenn


N/A

January of MS3 year. Used UWorld, Kaplan, Rx

Midway through third year (February). First Aid, UWorld, Pathoma. Did not start using these resources until third year.


studied for shelf exams exclusively in M2, haven't started Step 1 studying


N/A

Absolutely, having done UWorld Step 2 was very helpful for Step 1 Have not taken yet

Shelf exam and Step 2 study materials overlap. Also, shelf questions were helpful in prepping for Step 1.

No, took Step 2 December before graduation.

relying more on the overlap of clinics and Step 1 material rather than exclusively studying for Step 1


I forgot details, but the knowledge that I gained clinically has probably helped me master pathophys more than book studying would have.




not that I can think of

Although I haven't taken Step 1 or started dedicated test prep, I really like the way our system works. I feel like I have a much better understanding of the material than I did in my first two years, and I think that seeing a lot of the material firsthand in the clinic has helped me retain much more knowledge. N/A

1.5 years preclinicals --> 1 year core rotations --> Step 1 in February-ish of M3

Mid-July (most take in Feb/March though). Have not done VSAS because currently on a research year

Studied a few hours every night on weekdays and most of the Strengthened, clarified weekends many misconceptions

By mapping out which study resources and questions I needed to do before the start of the rotation Strengthened

Survey conducted by Elliott Fox, Medical Student at the Netter School of Medicine, in the Fall of 2016 via OSR Listserv Please email [email protected] with any questions or concerns

4

Flexibility is key. After clerkship year finished, we only had 12 months of graduation requirements to complete over an 18 month span. We were allowed to schedule our Step 1 and free blocks however we wanted to.

Absolutely Yes, absolutely. Taking shelf exams before Step 1 really helps prepare you for NBME style questions. Also, going through clerkship year makes any pharm or treatment question very easy. Lastly, there is much more flexibility to schedule the exam after the April 2015. It never end of clerkship year. affected VSAS.

1.5 preclinical, then step after 1 year of rotations (usually all but 1 core rotation)

1.5 year (18 month) preclinical period which includes a 6 week summer break. Step 1 is taken after clerkship rotations.

Step 1 During or After Core Clerkships, Fall 2016 - AAMC

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